The clinical foundation behind every cohort outcomes report.

Crucible Care’s 12-week protocol is grounded in three publicly auditable clinical frameworks: the CDC STEADI initiative for fall-risk screening, the Rikli & Jones senior fitness assessment battery, and the Sherrington 2019 Cochrane meta-analysis on exercise-based fall reduction. Every outcomes report we deliver maps to those frameworks explicitly. A regional VP, a state surveyor, or a family member who wants to understand the data can do so without a sales conversation.

01 · The assessment battery

Five clinical measures at baseline, midpoint, and final

Three of the five assessments are the CDC STEADI-recommended functional measures for community-dwelling older adults. The other two add depth on confidence and grip strength, both predictive in the published fall-risk literature.

• 30-second Sit-to-Stand

  Resident stands and sits from a standard chair as many times as possible in 30 seconds, without using the arms. Below-norm score is the strongest single predictor of fall risk in the Rikli & Jones literature.

• Timed Up & Go (TUG)

  Resident stands from a chair, walks 10 feet, turns, returns, and sits. Timed in seconds. CDC STEADI cut-point for elevated fall risk: ≥ 12 seconds.

• Single-Leg Balance

  Resident balances on one leg for as long as possible, up to 30 seconds. Tested on both legs; we use the best of the two. Below 10 seconds is a fall-risk marker.

• Grip Strength

  Handheld dynamometer reading, both hands. Tracks upper-body strength, predictive of independence in activities of daily living.

• Confidence (10-point self-rating)

  A simplified version of the ABC (Activities-specific Balance Confidence) scale. Adds the resident’s own voice to the audited shape — useful for catching changes the physical metrics don’t pick up.

02 · Composite fall-risk bands

Three bands. Worst-of-three rule.

For each resident, we score the three CDC-aligned measures (Sit-to-Stand, TUG, Single-Leg Balance) and take the worst of the three. That worst score classifies the resident into low, moderate, or high fall risk. The worst-of-three rule is conservative — a resident with two strong scores and one weak score still flags as the weak score’s band, because that’s the leverage point clinical intervention should focus on.

Across a cohort, we report band shifts in three lenses: individual residents who moved to a lower band (the audited headline), the full transition matrix (which baseline-band moved where), and a Sankey-style flow diagram that shows the shape of the cohort’s movement at a glance.

03 · The modeled cost-avoidance scenario

Sherrington 2019 + CDC 2020 cost figures

Every cohort report carries a modeled cost-avoidance scenario — the dollar exposure a facility could expect to avoid over the next 12 months if the cohort’s band-shift outcome held. The model applies a conservative fall-rate reduction factor (lower bound of the Sherrington 2019 Cochrane meta-analysis) to CDC 2020 direct-medical-cost-per-fall figures, weighted by the residents who exited the high-risk band.

We label this scenario as modeled, not measured on every artifact it appears on. The audited cohort outcomes (band shifts, attendance, assessment deltas) are measured at the facility. The dollar projection is a model built on top of them. Both numbers carry forward; the distinction is preserved everywhere a director, RVP, or surveyor reads the report.

04 · CMS F-tag mapping

F689 · F679 · F675

For state-survey readers, every cohort report carries a mapping to the relevant CMS F-tags:

• F689 — Free of Accident Hazards / Supervision / Devices

  The primary fall-risk tag. Crucible’s 12-week scripted strength and balance protocol, with five clinical assessments at baseline / midpoint / final, provides documented evidence of structured fall-risk mitigation programming.

• F679 — Activities

  The 24 scripted 45-minute sessions deliver structured activity programming. Average cohort attendance is documented per session, per resident.

• F675 — Quality of Life

  Per-resident composite improvements are tracked individually. Family-facing communication runs via per-resident bearer-token magic links — no PHI is exposed in shared URLs.

05 · Sources

Where the framework comes from

• CDC STEADI

  Stopping Elderly Accidents, Deaths & Injuries — the CDC’s clinical fall-prevention initiative for community-dwelling older adults. Includes screening tools, assessment cut-points, and intervention guidance. Reference: cdc.gov/steadi.

• Rikli & Jones Senior Fitness Test

  The standardized fitness assessment battery for adults aged 60-90+, with normative data by age band. The published norms let a cohort report compare a resident’s score against a peer-age expectation, not just against their own baseline.

• Sherrington 2019 Cochrane meta-analysis

  Exercise for preventing falls in older people living in the community. Cochrane Database of Systematic Reviews, 2019. The evidence base for the modeled cost-avoidance scenario — we apply the conservative lower bound of the meta-analytic fall-rate reduction factor.